Ventilation/perfusion (V/Q) scanning in contemporary patients with pulmonary embolism: utilization rates and predictors of use in a multinational study

被引:0
作者
Pierre-Benoît Bonnefoy
Nathalie Prevot
Ghazaleh Mehdipoor
Alicia Sanchez
Jorge Lima
Llorenç Font
Aída Gil-Díaz
Pilar Llamas
Jesús Aibar
Behnood Bikdeli
Laurent Bertoletti
Manuel Monreal
机构
[1] Service de Médecine Nucléaire,Department of Medicine, Peconic Bay Medical Center
[2] CHU de Saint-Etienne,Department of Pneumonology
[3] INSERM,Department of Haematology
[4] UMR1059,Department of Internal Medicine
[5] Equipe Dysfonction Vasculaire et Hémostase,Department of Haematology
[6] Université Jean-Monnet,Department of Internal Medicine
[7] Northwell Health,Cardiovascular Medicine Division
[8] Cardiovascular Research Foundation (CRF),Center for Outcomes Research and Evaluation
[9] Hospital Universitario de Valme,Department of Internal Medicine
[10] Hospital de Tortosa Verge de La Cinta,undefined
[11] Hospital Universitario de Gran Canaria Dr. Negrín,undefined
[12] Hospital Universitario Fundación Jiménez Díaz,undefined
[13] Hospital Clínic,undefined
[14] Barcelona,undefined
[15] Brigham and Women’s Hospital,undefined
[16] Harvard Medical School,undefined
[17] Yale-New Haven Hospital,undefined
[18] Service de Médecine Vasculaire Et Thérapeutique,undefined
[19] INSERM,undefined
[20] CIC-1408,undefined
[21] CHU Saint-Etienne,undefined
[22] F-CRIN INNOVTE Network,undefined
[23] Hospital Universitari Germans Trias I PujolBadalona,undefined
[24] Barcelona,undefined
[25] Universidad Católica de Murcia,undefined
来源
Journal of Thrombosis and Thrombolysis | 2022年 / 53卷
关键词
Pulmonary embolism; Computed tomography angiography; V/Q scan; Radionuclide imaging;
D O I
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中图分类号
学科分类号
摘要
Ventilation/perfusion (V/Q) imaging and computed tomography pulmonary angiography (CTPA) are common tools for acute pulmonary embolism (PE) diagnosis. Limited contemporary data exist about the utilization of each modality, including the predictors of using V/Q versus CTPA. We used the data from patients diagnosed with PE using V/Q or CTPA from 2007 to 2019 in Registro Informatizado Enfermedad ThromboEmbolica, an international prospective registry of patients with venous thromboembolism. Outcomes was to determine the trends in utilization of V/Q vs. CTPA and, in a contemporary subgroup fitting with current practices, to evaluate predictors of V/Q use with multivariable logistic regression. Among 26,540 patients with PE, 89.2% were diagnosed with CTPA, 7.1% with V/Q and 3.7% with > 1 thoracic imaging modality. Over time, the proportional use of V/Q scanning declined (13.9 to 3.3%, P < 0.001). In multivariable analysis, heart failure history (odds ratio [OR]:1.5; 95% confidence interval [CI] 1.14–1.98), diabetes ([OR 1.71; 95% CI 1.39–2.10]), moderate and severe renal failure (respectively [OR 1.87; 95% CI 1.47–2.38] and [OR 9.36; 95% CI 6.98–12.55]) were the patient-level predictors of V/Q utilization. We also observed an influence of geographical and institutional factors, partly explained by time-limited V/Q availability (less use over weekends) and regional practices. Use of V/Q for the diagnosis of PE decreased over time, but it still has an important role in specific situations with an influence of patient-related, institution-related and logistical factors. Local and regional resources should be evaluated to improve V/Q accessibility than could benefit for this population.
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页码:829 / 840
页数:11
相关论文
共 106 条
[1]  
Raskob GE(2014)Thrombosis a major contributor to global disease burden Arter Thromb Vasc Biol 34 2363-2371
[2]  
Angchaisuksiri P(2015)Epidemiology of venous thromboembolism Nat Rev Cardiol 12 464-474
[3]  
Blanco AN(2002)Diagnostic strategy for patients with suspected pulmonary embolism: a prospective multicentre outcome study Lancet 360 1914-1920
[4]  
Heit JA(2001)Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and d-dimer Ann Intern Med 135 98-107
[5]  
Musset D(2019)2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society ( ERS ) the task force for the diagnosis and management of acute Eur Heart J 263 2753-2759
[6]  
Parent F(1990)Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED) JAMA 34 1109-1118
[7]  
Meyer G(1993)Ventilation-perfusion scintigraphy in the PIOPED study. Part I. Data collection and tabulation ventilation-perfusion scintigraphy in the PIOPED Study. Part I. Data collection and tabulation J Nucl Med 34 1119-1126
[8]  
Wells PS(1993)Ventilation-perfusion scintigraphy in the PIOPED study. Part II. evaluation of the scintigraphic criteria and interpretations J Nucl Med 84 1392-1400
[9]  
Anderson DR(2015)Planar and SPECT ventilation/perfusion imaging and computed tomography for the diagnosis of pulmonary embolism: a systematic review and meta-analysis of the literature, and cost and dose comparison Eur J Radiol 201 467-470
[10]  
Rodger M(1996)Pulmonary embolism: validation of spiral CT angiography in 149 patients Radiology 352 1760-1768